There is much controversy
over Hypermobility Syndrome (HMS) especially since there is no standardized test
for it's diagnosis or treatment. There is also some question as to whether HMS
and EDS III are one and the same; most authorities consider them to be and after
much research, so do I. One such authority that believes they are the same is
The Ehlers-Danlos National
Foundation who on their web site lists Hypermobility as formerly being
called EDS type III. HMS affects the collagenous tissues of the body
which include bone, cartilage, tendons, ligaments, and skin.

The following information
seen in greenhas been copied
directly from the The
Elhers-Danlos Nation Foundation site, though parts not pertaining to EDS III
hypermobility have been omitted.

Types of Ehlers-Danlos Syndrome
Ehlers-Danlos syndrome (EDS) is a heterogeneous group of heritable connective
tissue disorders characterized by articular (joint) hypermobility, skin
extensibility and tissue fragility. Individuals with EDS have a defect in their
connective tissue. It is this tissue that provides support to many body parts
such as the skin, muscles, ligaments and organs. The fragile skin and unstable
joints found in EDS are due to faulty collagen. Collagen is a protein that acts
like glue in the body adding strength and elasticity to connective tissue.

There are six major types of
EDS. The different types of EDS are classified according to the signs and
symptoms that are manifested. Each type of EDS is a distinct disorder that "runs
true" in a family. This means that an individual with Vascular Type EDS will not
have a child with Classical Type EDS.

Hypermobility (Formerly EDS Type III)
Joint hypermobility is the dominant clinical manifestation. Generalized joint
hypermobility that affects large (elbows, knees) and small (fingers and toes)
joints is evident in the Hypermobility Type. Recurring joint subluxations and
dislocations are common occurrences. Certain joints, such as the shoulder,
patella(knee cap), and temporomandibular(jaw) joint dislocate frequently. The
skin involvement (hyperextensibility and/or smooth velvety skin) as well as
bruising tendencies in the Hypermobility Type are present but variable in
severity.

Chronic
joint and limb pain is a common complaint amongst individuals with the
Hypermobility Type. Skeletal X-rays are normal. Musculoskeletal pain is early
onset, chronic and may be debilitating. The anatomical distribution is wide and
tender points can sometimes be elicited.

To
date, no distinctive biochemical collagen finding has been identified by
researchers. The Hypermobility Type of EDS is inherited in an autosomal dominant
manner.

The
following information in red
is from the Site called Health A to Z
you can link there to read the rest of the information.

Definition

The Ehlers-Danlos
syndromes (EDS) refer to a group of inherited disorders that affect collagen
structure and function. Genetic abnormalities in the manufacturing of collagen
within the body affect connective tissues, causing them to be abnormally weak.

Description

Collagen is a strong,
fibrous protein that lends strength and elasticity to connective tissues such as
the skin, tendons, organ walls, cartilage, and blood vessels. Each of these
connective tissues requires collagen tailored to meet its specific purposes. The
many roles of collagen are reflected in the number of genes dedicated to its
production. There are at least 28 genes in humans that encode at least 19
different types of collagen. Mutations in these genes can affect basic
construction as well as the fine-tuned processing of the collagen.

EDS was originally
described by Dr. Van Meekeren in 1682. Dr. Ehlers and Dr. Danlos further
characterized the disease in 1901 and 1908, respectively. Today, according to
the Ehlers-Danlos National Foundation, one in 5,000 to one in 10,000 people are
affected by some form of EDS.

EDS is a group of genetic
disorders that usually affects the skin, ligaments, joints, and blood vessels.
Classification of EDS types was revised in 1997. The new classification involves
categorizing the different forms of EDS into six major sub-types, including
classical, hypermobility, vascular, kyphoscoliosis, arthrochalasia, and
dermatosparaxis, and a collection of rare or poorly defined varieties. This new
classification is simpler and based more on descriptions of the actual symptoms.

There are many people in
society that are hypermobile, meaning that they have one or more joints that can
move beyond the normal range considering their age, gender and ethnicity
(populations of Asian descent are most mobile while those of European descent
are the least) , but
they are healthy and have little or no problems arising from their increased
mobility. Some of these people are not born hypermobile but acquire it through
training, like many dancers for example. HMS, however, is a pain syndrome that affects the hypermobile and you do not have to be hypermobile in all joints to be a
sufferer. Some rheumatologists see HMS more as a physiological problem than a
pathological one. Meaning that they think that the hypermobility seen in HMS
patients is nothing more than a variation in joint motion in the uppermost
distribution of a given population. They acknowledge that exercise could cause
pain in these individuals but that this is a minor problem unlikely to impair
their quality of life. Therefore making HMS a condition not to be taken
seriously. BUT there are other rheumatologists that view HMS as a pathological
entity and consider it to be a part of a group called "Heritable Connective
Tissue Disorders" or HDCT's. This view is based on the evidence of skin
involvement seen in HMS patients such as increased skin stretchiness, thin
crinkly scars and stretch marks (often in places where no significant weight
gain has occurred to warrant them, most often on thighs and lower back)

It is often unrecognized
and often difficult to diagnose resulting in the sufferer often being labeled as
"neurotic" or a "hypochondriac". HMS/EDS
III goes
unrecognized because suffers often have a wide variety of seemingly unrelated
symptoms. Also they often cannot connect the pain with a specific event or
action, and if they can the pain seems disproportionately high when compared to
the event and the currently mobility of the area. Often HMS/EDS III sufferers feel pain
and stiffness but retain enough mobility in the joint to be seen as normal.
However, for the individual the movement may be greatly restricted in comparison
with their normal hypermobile range. HMS sufferers do not tolerate repetitive or
excessive activity well and tend to suffer symptoms after the activity rather
than during it (24-48 hrs later). This makes it hard to connect the pain to the
cause. Especially since the excessive activity could have been an everyday
activity done a little longer than normal or a little more frequently. The
symptoms are often similar to those seen is soft tissue strain but there is
often no accompanying signs of inflammation. HMS patients also note that they
cannot maintain a sustained posture such as sitting or standing for prolonged
periods. They are often considered fidgety people who feel like they are
constantly trying to get comfortable.

Since HMS affects collagen tissues there can
be associated problems in other systems of the body. Patients report that they
bruise more easily and often have no memory of how or when they could have done
it. There is reports of higher incidences of varicose veins in HMS and the
suggestion that HMS can also have laxity involving blood vessels. There is also
evidence to suggest a higher incidence of uterine prolapse and abdominal
hernias. Getting back to joints, dislocations and subluxations are more common
in those with HMS. Spontaneous relocation often occurs (specially the first
time). Dislocations and subluxations thereafter often occur with no trauma and
some people can sublux and relocate joints at will with little pain or
discomfort (most commonly the shoulder or patella=knee cap ).

There are other physiological and
psychological abnormalities that have come to light in connection with HMS.
Impaired joint proprioceptive acuity (the
proprioceptive system communicates with the brain so that even if your eyes are
closed, you can tell which direction your arms are pointed, whether you are
upside-down or just feel the presence of your own body. HMS sufferer often have
an impaired ability to accurately know where their limbs etc are in space
without looking at them. This makes it more easy to over extend joints and not
know it). People with HMS also experience a lack of efficacy of local
anesthetics either given topically or by injection. This is often problematic
and distressing when having dental surgery, during childbirth (using epidural)
or in minor surgery. Pain enhancement is
another common problem leading to the development of a full chronic pain
syndrome, resulting in acute and chronic pain being the dominant factor of every
day life. There is also a significant association between HMS and anxiety
states with panic attacks and phobic states. Panic disorder, agoraphobia and
simple phobias are four(4) times more common among HMS patients. Recently
Autonomic dysfunction was added to the list since HMS sufferer can complain of
palpitations, light-headedness, dizziness or fainting, which are similar
symptoms to those of patients with autonomic nervous system dysfunction.

Diagnosis of HMS often made by ruling out other rheumatological disorders,
taking family history and rating hypermobility using one of the scales such
as the beighton score or the more comprehensive Contompasis semi-qualitative
scoring system. The most fruitful areas of the body to find hypermobility are
the following

*hands with fingers outstretched

* wrist flexion and extension

* lateral rotation of the shoulder (90
degrees or more)

* cervical spine = neck (rotation to right or
left to 90 deg or more or lateral flexion to left or right greater than 60 deg)